PC Authorization Associate II

Piedmont Healthcare Inc. • Atlanta, GA

1d

About The Position

The PC Authorization Associate II contacts insurance companies and other third-party payers to determine pre-certification, pre-authorization, and/or medical necessity requirements for complex outpatient hospital services and specialized procedures, such as Recurring Visits, Surgeries, and IR. This role involves obtaining pre-certification or pre-authorization prior to the scheduled complex service being performed. The associate also liaisons with physicians and physician office staff as needed to gather additional demographic, insurance, or clinical information and notifies payers of admittance if required.

Requirements

• H.S. Diploma or General Education Degree (GED)
• 3 years exp in Rev Cycle or related exp in healthcare, with one of those years working specifically within Healthcare Revenue Cycle
• None (Licenses and Certifications)

Nice To Haves

• Bachelor’s Degree from a recognized college or university
• Completion of medical coder training program
• 4 years of previous related healthcare Revenue Cycle experience
• Prior Epic experience
• Clinical experience (i.e., medical assistant, surgical tech)
• Certification with Healthcare Financial Management Association
• Certified Revenue Cycle Representative

Responsibilities

• Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient hospital services, and specialized procedures (i.e. Recurring Visits, Surgeries, IR).
• Obtains pre-certification or pre-authorization prior to the scheduled complex service being performed.
• Liaisons with physicians and physician office staff when needed to obtain additional demographic, insurance or clinical information.
• Notify payers of admittance if required.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees